Pulmonary embolism presenting as syncope: a case report

<p>Abstract</p> <p>Introduction</p> <p>Despite the high incidence of pulmonary embolism its diagnosis continues to be difficult, primarily because of the vagaries of symptoms and signs in presentation. Conversely, syncope is a relatively easy clinical symptom to detect, but has varied etiologies that lead to a documented cause in only 58% of syncopal events. Syncope as the presenting symptom of pulmonary embolism has proven to be a difficult clinical correlation to make.</p> <p>Case presentation</p> <p>We present the case of a 26-year-old Caucasian man with pulmonary embolism induced-syncope and review the pathophysiology and diagnostic considerations.</p> <p>Conclusions</p> <p>Pulmonary embolism should be considered in the differential diagnosis of every syncopal event that presents at an emergency department.</p

Comparison of the efficacy of propofol and metoclopramide in preventing postoperative nausea and vomiting after middle ear surgery

Arslan, Mustafa/0000-0003-4882-5063WOS: 000269349300007PubMed: 19526159Objectives: To compare the administration of sub hypnotic dose of propofol with metoclopramide and placebo in prevention of postoperative nausea and vomiting (PONV) after middle ear surgery. Methods: This clinical research was performed in the Faculty of Medicine, Gazi University, Besevler, Ankara, Turkey, between December 2004 and October 2005. Following approval by the hospital ethics committee, 60 adult patients scheduled for a middle ear operation were randomly assigned into 3 groups. The patients in group P received 0.5 mg.kg(-1) propofol; in group M, 0.2 mg.kg(-1) metoclopramide, and in group C, 0.9% saline solution. The number of patients suffering from nausea and vomiting at 0-4, 4-12, and 12-24 hours postoperatively, and additional use of antiemetics was recorded. Results: Comparison of the data showed that at 0-4th hours, the incidence of vomiting was 25% in group P, 40% in group M, and 75% in group C. The incidence rate of group P was significantly lower than that of group C (p=0.002), and the rate of antiemetics use in group C was higher than that in group P (p=0.028). The Nausea Vomiting Scale scores of group C were also significantly higher than those of group P (P=0.005). There were no significant differences between the values at 4-12 and 12-24 hours. Conclusion: The administration of a sub hypnotic dose of propofol at the end of surgery was found to be at least as effective as metoclopramide in preventing PONV in the early postoperative period in adult patients undergoing middle ear surgery